Individual
MR. TODD MASON RENEGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
4024 MAYFLOWER BLVD, ALEXANDRIA, LA 71303-2913
(646) 258-3479
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0866174-1
NY
Other
Enumeration date
09/08/2018
Last updated
09/21/2022
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